PROCTOSIGMOIDOSCOPY

HOLLY MAE P. TANDOC

 outline
• Anatomy of the Colon
• Proctosigmoidoscopy Overview
• Indications
• Risks/Complications
• Equipments
• Procedure (Before, During, After)
 Anatomy of the colon
The large intestine, or colon, has four sections:
• Ascending colon
• Transverse colon
• Descending colon
• Sigmoid colon

• Sigmoid colon is named because of its S-shape

and extends from the descending colon to the rectum
• The rectum joins the anus, or the opening where waste
matter passes out of the body.
Anatomy of the colon
 PROCTOSIGMOIDOSCOPY
• Is a diagnostic procedure that allows
the doctor to examine the anus, rectum, and
distal sigmoid colon (lower one-third of the
large intestine)
 Indications
• INDICATIONS:
– To visualize or diagnose colon polyps, tumors,
ulceration, inflammation, hemorrhoids, diverticula
(pouches), and strictures (narrowing) in the sigmoid
colon
– To identify the causes of diarrhea, abdominal pain,
constipation, abnormal growths, and bleeding
– To obtain biopsies and to perform procedures, such
as removal of polyps or hemorrhoids
– To screen for colorectal cancer
 Risks/complications
• As with any invasive procedure, complications
may occur.
• Complications related to sigmoidoscopy may
include, but are not limited to, the following:
– Persistent bleeding after biopsy
– Peritonitis (inflammation of the lining of the abdominal
cavity)
– Perforation of the intestinal wall (rare)
 equipments
• Light source
• Suction apparatus
• Biopsy forceps
• K-Y Jelly
• 4X4 inch gauze pads
• Nonsterile gloves
• Water container (for suction)
• Specimen container
• Video unit and monitor
• Sigmoidoscope
 equipments
• SIGMOIDOSCOPE - a short, flexible, lighted tube,
which is inserted into the intestine through the
rectum into the lower part of the large intestine.
• A tiny video camera at the tip of the tube allows
the doctor to view the inside of the rectum and
most of the sigmoid colon — about the last two
feet (61 centimeters) of the large intestine.
• Air is injected into the intestine through the
sigmoidoscope to inflate it for better viewing.
sigmoidoscope
sigmoidoscope
 procedure - before
BEFORE THE PROCEDURE, the patient may be asked to:
• Follow a special diet the day before the exam. 
– Typically, patient won’t be able to eat the day before the
exam.
– Drinks may be limited to clear liquids — plain water, broth,
carbonated beverages and tea and coffee without milk or
cream.
– You may not be able to eat or drink anything after midnight
the night before the exam.
• Take a laxative the night before the exam. 
 Procedure - before
• Use an enema kit.
– It is done either the night before the exam or a few
hours before the exam — to empty your colon.
• Adjust your medications. 
– Remind your doctor of your medications at least a
week before the exam — especially if you take
aspirin or other blood thinners. You may need to
adjust your dosages or stop taking the medication
temporarily.
procedure - during
 Procedure – during
1. The patient will be asked to remove any jewelry or
other objects that may interfere with the procedure.
2. The patient will be asked to remove clothing and be
given a gown to wear.
3. The patient will be asked to lie on the procedure table
on your left side with your knees bent towards your
chest. (left
4. The doctor will conduct a rectal exam to check for the
presence of blood, mucus, or fecal matter and to help
dilate the anus.
 PROCedure - DURING
5. A lubricated sigmoidoscope will be slowly
inserted into the anus and advanced into the
rectum and lower part of the colon (distal
sigmoid colon).
6. After the sigmoid colon is visualized, the
sigmoidoscope will be removed.
7. Air may be introduced into the bowel to aid
visualization. A suction device may be used to
remove liquid feces.
 PROCedure - DURING
9. During the procedure, specimens and/or
biopsies (tissue samples) may be taken from
the lining of the large intestine with a special
brush, forceps, or swab.
10.If a polyp is seen, it may be removed,
biopsied, or left alone until a subsequent
operation is performed.
11.After the procedure is completed, the
instrument will be removed.
 PROCEDURE - after
1. The patient should lie on his side or back for a few minutes
before getting up from the table. You should move slowly when
standing up in order to avoid dizziness from having your head
down during the procedure.
2. You may resume your normal diet and activities, unless
otherwise instructed.
3. If a biopsy or polyp removal was done during the procedure,
you may notice a small amount of blood in your bowel
movement. This bleeding should stop within a day or so.
4. You may experience excessive flatulence (passing of gas) and gas
pains after the procedure. This is normal. Walking and moving
about may help to ease any discomfort.
 PROCedure - after
Notify your doctor to report any of the following:
1. Fever and/or chills
2. Bleeding from the rectum that lasts longer than a
day
3. Abdominal pain and/or bloating
4. Inability to pass gas
5. Following a sigmoidoscopy, your doctor may give
you additional or alternate instructions after the
procedure, depending on your particular situation.
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